Collateral Damage

I would say I did not do terrible on the Health Equity Quiz, but with a score of 6/10 there were a few statistics that surprised me. For one, even though our life expectancy continues to fall beneath other industrialized nations, we are spending nearly half of all health care dollars in the world. You would think that because we are spending so much money on health care that our health would be better than it actually is. It makes me wonder, where is all of this money going? Who is it benefitting? How can it be used better? Obviously, what we are doing now is not the best option.

This discrepancy between money spent on health care and actual health in the US was illustrated in Unnatural Causes: Collateral Damage. The episode was not based in the US. However, I believe it showcases how we spend a lot of our resources on attempting to fix health care problems with money and modern medicine instead of addressing or preventing the root cause of the issue. From here, we see the health gap grow between the poor and the wealthy.

To Summarize Collateral Damage, it is based on the Marshall Islands (between Australia and the US) and discusses how the Marshallese people’s health is linked to their relationship with the US. The Marshall Islanders used to be known as “Masters of the Pacific,” based upon their use of astronomy and rich navigation knowledge. Today, the Marshallese are pressed between two worlds, developing and industrial, and sometimes referred to as “the slum of the pacific.” So how did the islanders go from one extreme to the next? This story starts when the US invaded the islands during WWII. From here, the US started using the Marshall Islands as a nuclear test site. Hiroshima is often regarded as one of the most horrific moments in the 20th century. On the Marshall Islands, for 12 years (1946 – 1958) the equivalent of 1.7 Hiroshima bombs went off every day on average. This testing had some catastrophic repercussions, including Marshallese contact with nuclear fallout. These people were treated, relocated, and then tracked and studied to observe the long-term effects of nuclear fallout on humans. Not only was their health compromised in favor of nuclear testing, they were also forced to move in order to continue nuclear testing.

On top of the nuclear testing, the Marshallese are currently facing health problems that are associated with overcrowding and poverty. While the US military occupies one suburban island as a military base with a country club and running water, the Marshallese people are packed on small islands, with hardly enough water to drink, let alone do their laundry or have an indoor toilet. The Marshallese essentially are forced to work for the American citizens. They get to watch the Americans live the good life, while their health diminishes. The Marshallese have to worry about tuberculosis and cholera, not because of genetics but because environmental predisposition. Since the US began occupation of the Islands the Marshallese have lost much of their cultural practices and nutritional diet. No longer do they have the room or the amenities to keep a balanced diet, they are much too busy dealing with poverty, malnutrition, overcrowding, and working under new cultural pressures. For these stressful environmental reasons, we see such strong health disparities between the Marshallese and the Americans who live on an island only a three-mile fairy ride away. In hindsight, it appears the Marshall Islanders would have been much better off if the US never came and tried to develop the islands – it has hurt the health of the Marshallese is multiple ways that correlate with American involvement with the islands. Further, it is going to take a lot of time and money to reverse even a fraction of the damage that has been done to the islanders’ health and culture.

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